JACC. Case reports · 2026
Biologic Rescue With Tocilizumab: A Case of Refractory Chronic Pericardial Effusion in Systemic Sclerosis.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Delgadillo Ramses, Roufeh Elliot, Lavelle Bianca, Nguyen Kaylin, de la Rosa Angelo
Аннотация
BACKGROUND: Pericardial effusions in systemic sclerosis (SSc) are usually mild; large or refractory effusions are rare.
CASE SUMMARY: A 63-year-old woman with diffuse cutaneous SSc, interstitial lung disease, and secondary Sjögren syndrome presented with worsening dyspnea and a large chronic pericardial effusion. Despite pericardiocentesis, drain repositioning, colchicine, corticosteroids, and surgical pericardial window, she had persistent high-output drainage. Tocilizumab, an interleukin-6 (IL-6) receptor antagonist, was initiated for suspected autoimmune serositis, resulting in rapid decline in pericardial drain output and sustained improvement on serial transthoracic echocardiography.
DISCUSSION: This case highlights IL-6-driven inflammatory serositis as a mechanism of refractory pericardial effusion in SSc and demonstrates the therapeutic benefit of IL-6 receptor blockade.
TAKE-HOME MESSAGE: IL-6-mediated serositis should be considered in refractory SSc effusions; tocilizumab may be effective when standard therapies fail.
CASE SUMMARY: A 63-year-old woman with diffuse cutaneous SSc, interstitial lung disease, and secondary Sjögren syndrome presented with worsening dyspnea and a large chronic pericardial effusion. Despite pericardiocentesis, drain repositioning, colchicine, corticosteroids, and surgical pericardial window, she had persistent high-output drainage. Tocilizumab, an interleukin-6 (IL-6) receptor antagonist, was initiated for suspected autoimmune serositis, resulting in rapid decline in pericardial drain output and sustained improvement on serial transthoracic echocardiography.
DISCUSSION: This case highlights IL-6-driven inflammatory serositis as a mechanism of refractory pericardial effusion in SSc and demonstrates the therapeutic benefit of IL-6 receptor blockade.
TAKE-HOME MESSAGE: IL-6-mediated serositis should be considered in refractory SSc effusions; tocilizumab may be effective when standard therapies fail.